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进退两难。一则简短的病例报告。

A rock in a hard place. A brief case report.

作者信息

Cina S J, Gelven P L, Nichols C A

机构信息

Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston 29425, USA.

出版信息

Am J Forensic Med Pathol. 1995 Dec;16(4):333-5. doi: 10.1097/00000433-199512000-00007.

Abstract

Radiographs are often of assistance in locating foreign bodies, particularly bullets, at autopsy. It must be remembered, however, that all bullet-shaped radioopacities that appear to be within the skull are not necessarily projectiles. Described is a radiographic conundrum caused by a piece of gravel that pierced the scalp when the victim of a gunshot wound to the head fell to the ground. The stone, although bullet shaped, differed in radiodensity to metal and could have been recognized for what it was prior to much consternation on the part of the prosecutors. This case serves as a reminder of two pitfalls in the interpretation of gunshot wounds to the head. First, the radiodensity of a foreign body must be considered as important as its shape. Second, a foreign body outside of the convex surface of the skull may appear intracranial on both anteroposterior and lateral radiographs. Last, the prosecutor is encouraged to remain open minded and not to simply "see what he/she wants to see."

摘要

在尸检时,X光片常常有助于定位异物,尤其是子弹。然而,必须记住的是,所有看似在颅骨内的子弹状不透射线影像不一定都是投射物。本文描述了一个因一块碎石引发的X光检查难题,在一名头部枪伤受害者倒地时,这块碎石穿透了头皮。这块石头虽然呈子弹形状,但在放射密度上与金属不同,在检方大为惊慌之前,本可以识别出它的真实面目。这个案例提醒人们在解读头部枪伤时有两个陷阱。第一,异物的放射密度与其形状同样重要。第二,位于颅骨凸面之外的异物在前后位和侧位X光片上可能会显示在颅内。最后,鼓励检方保持开放的心态,不要只是“看到自己想看到的东西”。

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